| 椎动脉优势现象与后循环缺血相关性临床分析 |
| 投稿时间：2014-09-14 修订日期：2014-10-28 点此下载全文 |
| 引用本文：夏文卿,牛国忠,殷聪国,唐波,蒋琳.椎动脉优势现象与后循环缺血相关性临床分析[J].医学研究杂志,2015,44(11):122-124 |
| DOI：
10.11969/j.issn.1673-548X.2015.11.034 |
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| 中文摘要:目的 探讨后循环缺血(posterior circulation ischemia,PCI)与椎动脉优势(vertebral artery dominance,VAD)现象的相关性以及VAD患者合并PCI的危险因素。方法 选取2011年10月~2012年10月期间在杭州市第一人民医院神经内科收治的脑梗死/TIA患者,根据脑血管影像学检查结果分为VAD组和非VAD组,根据牛津郡社区脑卒中项目分型标准分为前循环组和后循环组。回顾性收集人口统计学、动脉粥样硬化危险因素、影像学和其他临床资料并进行分析比较。结果 PCI组有VAD的危险比前循环组高2.363倍,而存在VAD的病例出现PCI的危险是没有该血管变异者的1.639倍。在128例伴有VAD的脑梗死/TIA患者中,后循环组冠心病患者比例(11.0% vs 28.3%,P=0.013)显著小于前循环组,基底动脉弯曲比例(86.6% vs 19.6%,P=0.000)显著高于前循环组,多变量Logistic回归分析显示,基底动脉弯曲可能是VAD患者PCI的独立危险因素(OR=36.505,95%CI:9.778~71.850,P=0.000)。结论 VAD与PCI存在相关性,基底动脉弯曲可能是VAD患者合并PCI的独立危险因素。 |
| 中文关键词:后循环缺血 脑梗死 短暂性脑缺血发作 椎动脉优势现象 危险因素 |
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| Clinical Analysis of Vertebral Artery Dominance and Posterior Circulation Ischemia. |
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| Abstract:Objective To investigate the correlation between posterior circulation ischemia(PCI) and vertebral artery dominance(VAD) and the risk factors of PCI in patients with VAD. Methods Patients with acute cerebral infarction or transient ischemic attack were employed,which were hospitalized in neurology of the first hospital in hangzhou affiliated to Nanjing medical university.Based on the results of cerebrovascular imaging examination,all of the patients were divided into group of patients with VAD and group of patients without VAD.According to Oxfordshire community stroke project classification standards,all patients were divided into group of anterior circulation and group of posterior circulation.Atherosclerosis risk factors,imaging and other clinical information of these patients were collgeted and compared. Results VAD was associated with PCI.The number of patients with PCI was 2.363 times higher than patients with anterior circulation ischemia(ACI),and the risk of PCI in patients with VAD was 1.639 times higher than patients without VAD. There were 128 patients with PCI or TIA which had VAD.Patients with PCI had significantly lower proportion of coronary heart disease(11.0% vs 28.3%,P=0.013)and higher proportion of distortion in base artery(86.6% vs 19.6%,P<0.001) than patients with ACI.There also was significantly difference in CI and TIA.Multivariate Logistic regression analysis showed that distortion in base artery was the independent risk factor for PCI in patients with VAD(OR:36.505,95%CI:9.778-71.850,P=0.000). Conclusion VAD was associated with PCI.Distortion in base artery may be the independent risk factor for PCI in patients with VAD. |
| keywords:Posterior circulation ischemia Circulation infarction Transient ischemic attack Vertebral artery dominance Risk factor |
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